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K25.5
ICD-10-CM
Graham Patch Repair of Stomach Ulcer

Find information on Graham Patch Repair of Stomach Ulcer diagnosis including ICD-10-CM code, CPT codes, medical billing, clinical documentation improvement, healthcare coding guidelines, and physician query templates. Learn about appropriate documentation for stomach ulcer repair, surgical coding for Graham patch procedure, and best practices for accurate medical coding and reimbursement. This resource provides comprehensive guidance for healthcare professionals involved in coding and documenting Graham Patch Repair of Stomach Ulcer.

Also known as

Omental Patch Repair
Gastric Ulcer Repair with Omental Patch

Diagnosis Snapshot

Key Facts
  • Definition : Surgical closure of a perforated stomach ulcer using a piece of omentum.
  • Clinical Signs : Sudden severe abdominal pain, rigidity, tenderness, nausea, vomiting, fever.
  • Common Settings : Emergency room, operating room, surgical intensive care unit.

Related ICD-10 Code Ranges

Complete code families applicable to AAPC K25.5 Coding
K25-K28

Peptic ulcer

Covers gastric, duodenal, and peptic ulcers.

O60-O60

Preterm labor

Not directly related but may be present if ulcer causes stress.

K92-K92

Other disorders of stomach

May include complications or related conditions of stomach ulcers.

Code-Specific Guidance

Decision Tree for

Follow this step-by-step guide to choose the correct ICD-10 code.

Is the Graham Patch repair for a perforated gastric ulcer?

Code Comparison

Related Codes Comparison

When to use each related code

Description
Graham Patch Stomach Ulcer Repair
Oversewing of Stomach Ulcer
Wedge Resection Stomach Ulcer

Documentation Best Practices

Documentation Checklist
  • Graham patch repair stomach ulcer ICD-10 documentation
  • Confirm ulcer location, size, and cause (e.g., H. pylori)
  • Document omental patch size and fixation technique
  • Record hemostasis method and any complications
  • Post-op instructions, follow-up plan for ulcer management

Coding and Audit Risks

Common Risks
  • Unlisted Code Usage

    Incorrect use of unlisted procedure code when a specific Graham Patch repair code exists, leading to claim denials and revenue loss.

  • Unspecified Location

    Lack of documentation specifying ulcer location (gastric, duodenal) impacting code selection, reimbursement, and quality metrics.

  • Missed Coded Diagnoses

    Failure to code associated diagnoses like hemorrhage, perforation, or obstruction with the Graham Patch repair, affecting DRG assignment and payment.

Mitigation Tips

Best Practices
  • Document ulcer location, size, and edges for accurate ICD-10-PCS coding.
  • Code Graham patch repair using appropriate CPT codes for compliance.
  • Ensure operative report details patch material and technique for CDI.
  • Precise HPI crucial for medical necessity and risk adjustment coding.
  • Query physician for clarification if documentation lacks specificity.

Clinical Decision Support

Checklist
  • Confirm Dx: Gastric/duodenal ulcer perforation
  • Verify free air under diaphragm on imaging
  • Omental patch adequate: covering perforation
  • Document ulcer location and size precisely
  • Assess hemodynamic stability pre/post-op

Reimbursement and Quality Metrics

Impact Summary
  • Graham Patch Repair Stomach Ulcer Reimbursement: CPT 43840 impacts DRG assignment and case mix index.
  • Coding accuracy crucial: ICD-10-CM K25.x ensures correct reimbursement for ulcer repair.
  • Quality metrics impact: Post-op complications (surgical site infection) affect hospital value-based purchasing.
  • Timely, accurate coding and documentation maximize reimbursement, minimize denials for ulcer procedures.

Streamline Your Medical Coding

Let S10.AI help you select the most accurate ICD-10 codes. Our AI-powered assistant ensures compliance and reduces coding errors.

Quick Tips

Practical Coding Tips
  • Code primary diagnosis as stomach ulcer
  • Document ulcer location, size, and type
  • Verify Graham patch documentation details
  • Consider K25-K28 for ulcer diagnosis codes
  • Link procedure to diagnosis for reimbursement

Documentation Templates

Patient presented with complaints consistent with peptic ulcer disease, including epigastric pain, described as burning or gnawing, often relieved by food or antacids.  Symptoms were suggestive of a gastric ulcer, prompting further investigation.  Physical examination revealed tenderness to palpation in the epigastric region.  Relevant medical history includes documented Helicobacter pylori infection treated previously with triple therapy.  Upper gastrointestinal endoscopy confirmed the presence of a bleeding gastric ulcer located on the anterior wall of the stomach.  Hemostasis was achieved via endoscopic injection therapy.  Due to the size and location of the ulcer, a Graham Patch repair was performed using an omental patch secured with endoscopic clips.  The procedure was performed without immediate complications.  Diagnosis: Gastric ulcer, bleeding.  Procedure: Endoscopic Graham Patch repair of gastric ulcer.  Plan:  Continue proton pump inhibitor therapy.  Repeat endoscopy in 8 weeks to assess ulcer healing.  Patient education provided regarding ulcer prevention strategies, including dietary modifications and medication compliance.  Follow-up scheduled with gastroenterology.  ICD-10-CM code K25.0 for gastric ulcer, acute with hemorrhage, and CPT code 43257 for laparoscopic Graham Patch repair of gastric ulcer are documented for billing purposes.  Differential diagnosis included gastritis, duodenitis, and gastroesophageal reflux disease.